The has FDA approved labiplasty in the United States even though the American College of Obstetricians and Gynecologists issued a statement in 2007 against the procedure,

These procedures are not medically indicated, and the safety and effectiveness of these procedures have not been documented. Clinicians who receive requests from patients for such procedures should discuss with the patient the reason for her request and perform an evaluation for any physical signs or symptoms that may indicate the need for surgical intervention. Women should be informed about the lack of data supporting the efficacy of these procedures and their potential complications, including infection, altered sensation, dyspareunia, adhesions, and scarring.

The New View Campaign has started a petition, asking people to sign it and urge the FTC to regulate labiaplasty more strictly. I believe that this is an excellent course of action. Because sometimes these surgeries are performed because a person has a legitimate medical need, and because I believe that people should be able to modify their bodies as they see fit, I am not in favor of prohibiting this procedure. However, because of the risks involved, I do believe that women must be informed of them so that they can make an educated decision. Requiring surgeons to inform patients of all of the risks involved is one of the provisions the New View Campaign is calling for.

This entry was posted on Sunday, January 22nd, 2012 at 6:00 am and is filed under Editorials.
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5 Responses to “Letter Writing Sunday Oversight for Labiaplasty”

Appreciate you bringing attention to this often disregarded topic. Especially appreciate you saying “…because I believe that people should be able to modify their bodies as they see fit, I am not in favor of prohibiting this procedure.”

All to often I find people blindly dismissing these procedures as crazy when my personal experience has been that they help thousands of women each year.

We can both agree that stronger oversight of the doctors performing these surgeries would seem to be good for all involved. And in my opinion, ACOG really dropped the ball by dismissing these procedures. In fact the vast majority of botched surgeries I deal with are done by regular GYNs.

Most of the risk involved with these procedures has to do with the experience of your surgeon.

I’m curious. Do you know if the same type of regulation being sought here is in place for other cosmetic procedures?

Just because I would not support outlawing this procedure doesn’t mean I think it’s always a good thing. Some people have a medical need, but for others it’s sheerly cosmetic. However, as documented in “The Perfect Vagina” most women do not know the wide variety of sizes and shapes of labia that occur in nature. And so these women may think they are horribly deformed, but are really quite average. I find it quite distasteful that some doctors keep this information from their patients. If I were to consider breast implants, a surgeon might talk about what size would look best for my body type, but I am under no delusion that not being a D-cup makes me a freak. My hair stylist would think I was crazy if I asked for a dye job because of my unnaturally brown hair. This is not so for many women considering labiaplasty. It is for this reason I do not quite agree that the ACOG “dropped the ball.” Unlike breast implants, tattoos or piercings, you can’t undo getting your labia cut off.

Do you have any evidence that the negative effects cited by ACOG only occur in less experienced physicians?

Thanks for your response and appreciate your willingness to learn more about this topic and the woman actually having the surgery.

However, your statement “most women do not know the wide variety of sizes and shapes of labia that occur in nature”, is debatable at best. If you mean teenage girls, then I may agree.

Fact is, I would caution anybody forming opinions on this topic to be careful with what they gleam from statistics and information coming out of the U.K. (i.e. The Perfect Vagina). As represented in the film, the U.K. does seem to have a disproportionate number of 12-16 year old girls that believe there is something wrong with their labia. Being American and not British, I am not sure what all of the cultural drivers for this are (but the fact many are done for free by the NHS probably doesn’t help). All I can tell you is that the typical patient in the U.K. is different from the typical patient I interact with in Australia, Canada or the U.S. So that sample in my opinion is skewed and limited in scope.

Your comparison to breast implants or tattoos is really apples to oranges. A labia reduction would be more similar to a nose job, breast reduction or liposuction, all of which you cannot “undo”. And there are far more of those surgeries happening every year than there are vaginal surgeries. Thus my question about whether or not similar regulations exist for those procedures.

Did you take a closer look at the “negative effects” cited by ACOG? “Infection, altered sensation, dyspareunia, adhesions, and scarring”. With the exception of dyspareunia (painful intercourse), those are risks of any surgical procedure. And painful intercourse would be the result of just about any vaginal surgery (anterior/posterior repair, i.e “medically necessary surgery too), prolonged pain is usually associated with having the vagina overtightened by a presumably inexperienced surgeon.

If you were having a root canal, would you rather it be done by an oral surgeon doing his 1st root canal or one doing his 1000th root canal? Why? Because the one that has done 1000 has more experience with different patients, techniques, possible complications, etc. They’ve seen more. If a problem comes up, they’ll know how to handle it.

Why would it be different with vaginal procedures? The reason ACOG dropped the ball is because they know full well that their members have been doing these procedures for decades (tightenings & labia reductions). They just hadn’t been marketing them for sexual benefits. Instead of stepping up and acknowledging the procedures and providing the oversight that is now being sought, they chose to denounce them in the hopes they would scare women from wanting them. And really the issue was more with a particular doctor’s marketing approach and not really with the surgery. If you were to ask any doctor that performs these “tightenings” they would say they are not very different than the A&P repairs they learn in residency.

We women are not as weak and impressionable as some would like us to believe. It is infuriating to me that we women would suggest or propagate that sentiment.

Women are not stupid and easily misled. The vast majority of women I work with have been contemplating the procedures for years before they choose to go through with them. In interacting with doctors from all over the world, I routinely hear that their labiaplasty patients are the most satisfied post-op patients they have.

But since this is such a private procedure you don’t often hear them screaming from the rooftops about it. And why would they when they are deemed as “victims of society” for desiring the surgery. Is it not our right as women to desire to live happy, healthy and comfortable lives? Or does that make us weak, naive women that all want to look like porno stars?

In the end all this publicity does is make more women aware that these procedures are available. And while some will be outraged, the truth is whether you approve, ACOG approves or I disapprove, these women want these surgeries and will have them.

The answer is EDUCATION. Educate these women, that if they are going to have surgery, know what to look for, questions, things to avoid, etc. There will always be ethical and unethical individuals period, yes even in medicine….